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• W2788590128 abstract "No AccessJournal of UrologyAdult Urology1 Jul 2018Low Intensity Shock Wave Treatment for Erectile Dysfunction—How Long Does the Effect Last? Noam D. Kitrey, Yoram Vardi, Boaz Appel, Arik Shechter, Omar Massarwi, Yasmin Abu-Ghanem, and Ilan Gruenwald Noam D. KitreyNoam D. Kitrey Urology Department, Sheba Medical Center, Ramat-Gan, Israel More articles by this author , Yoram VardiYoram Vardi Urology Department, Sheba Medical Center, Ramat-Gan, Israel Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel More articles by this author , Boaz AppelBoaz Appel Neurourology Unit, Rambam Healthcare Campus, Haifa, Israel Financial interest and/or other relationship with Medispec. More articles by this author , Arik ShechterArik Shechter Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel Neurourology Unit, Rambam Healthcare Campus, Haifa, Israel More articles by this author , Omar MassarwiOmar Massarwi Neurourology Unit, Rambam Healthcare Campus, Haifa, Israel More articles by this author , Yasmin Abu-GhanemYasmin Abu-Ghanem Urology Department, Sheba Medical Center, Ramat-Gan, Israel More articles by this author , and Ilan GruenwaldIlan Gruenwald Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel Neurourology Unit, Rambam Healthcare Campus, Haifa, Israel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.070AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We studied the long-term efficacy of penile low intensity shock wave treatment 2 years after an initially successful outcome. Materials and Methods: Men with a successful outcome of low intensity shock wave treatment according to the minimal clinically important difference on the IIEF-EF (International Index of Erectile Function-Erectile Function) questionnaire were followed at 6, 12, 18 and 24 months. Efficacy was assessed by the IIEF-EF. Failure during followup was defined as a decrease in the IIEF-EF below the minimal clinically important difference. Results: We screened a total of 156 patients who underwent the same treatment protocol but participated in different clinical studies. At 1 month treatment was successful in 99 patients (63.5%). During followup a gradual decrease in efficacy was observed. The beneficial effect was maintained after 2 years in only 53 of the 99 patients (53.5%) in whom success was initially achieved. Patients with severe erectile dysfunction were prone to earlier failure than those with nonsevere erectile dysfunction. During the 2-year followup the effect of low intensity shock wave treatment was lost in all patients with diabetes who had severe erectile dysfunction at baseline. On the other hand, patients with milder forms of erectile dysfunction without diabetes had a 76% chance that the beneficial effect of low intensity shock wave treatment would be preserved after 2 years. Conclusions: Low intensity shock wave treatment is effective in the short term but treatment efficacy was maintained after 2 years in only half of the patients. In patients with milder forms of erectile dysfunction the beneficial effect is more likely to be preserved. References 1 : Can low-intensity extracorporeal shockwave therapy improve erectile function? A 6-month follow-up pilot study in patients with organic erectile dysfunction. Eur Urol2010; 58: 243. Google Scholar 2 : Extracorporeal shockwave therapy in the treatment of erectile dysfunction: a prospective, randomized, double-blinded, placebo controlled study. Int J Urol2014; 21: 1041. Google Scholar 3 : Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo-controlled study. Scand J Urol2014; 1805: 1. Google Scholar 4 : Low-intensity extracorporeal shock wave therapy—a novel effective treatment for erectile dysfunction in severe ED patients who respond poorly to PDE5 inhibitor therapy. J Sex Med2012; 9: 259. Google Scholar 5 : Does low intensity extracorporeal shock wave therapy have a physiological effect on erectile function? Short-term results of a randomized, double-blind, sham controlled study. J Urol2012; 187: 1769. Link, Google Scholar 6 : Shockwave treatment of erectile dysfunction. Ther Adv Urol2013; 5: 95. Google Scholar 7 : Low-intensity extracorporeal shock wave therapy in vascular disease and erectile dysfunction: theory and outcomes. Sex Med Rev2013; 1: 83. Google Scholar 8 : Effect of low-energy linear shockwave therapy on erectile dysfunction—a double-blinded, sham-controlled, randomized clinical trial. J Sex Med2017; 14: 106. Google Scholar 9 : Penile low intensity shock wave treatment is able to shift PDE5i nonresponders to responders: a double-blind, sham controlled study. J Urol2016; 195: 1550. Link, Google Scholar 10 : Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits. J Orthop Res2003; 21: 984. Google Scholar 11 Wang CJ, Huang HY and Pai CH: Shock wave-enhanced neovascularization at the tendon-bone junction: an experiment in dogs. J Foot Ankle Surg 41: 16. Google Scholar 12 : Minimal clinically important differences in the erectile function domain of the International Index of Erectile Function scale. Eur Urol2011; 60: 1010. Google Scholar 13 : EAU Guidelines on Erectile Dysfunction, Premature Ejaculation, Penile Curvature and Priapism. European Association of Urology, 2017. Available at http://uroweb.org/guideline/male-sexual-dysfunction. Accessed June 26, 2017. Google Scholar 14 : Low intensity extracorporeal shockwave therapy for erectile dysfunction: a study in an Indian population. Can J Urol2015; 22: 7614. Google Scholar 15 : Twelve-month efficacy and safety of low-intensity shockwave therapy for erectile dysfunction in patients who do not respond to phosphodiesterase type 5 inhibitors. Sex Med2016; 4: e225. Google Scholar © 2018 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byKalyvianakis D, Mykoniatis I, Pyrgidis N, Kapoteli P, Zilotis F, Fournaraki A and Hatzichristou D (2022) The Effect of Low-Intensity Shock Wave Therapy on Moderate Erectile Dysfunction: A Double-Blind, Randomized, Sham-Controlled Clinical TrialJournal of Urology, VOL. 208, NO. 2, (388-395), Online publication date: 1-Aug-2022.Seftel A (2018) Re: The Effect of Low-Intensity Extracorporeal Shockwave Therapy in an Obesity-Associated Erectile Dysfunction Rat ModelJournal of Urology, VOL. 200, NO. 3, (482-482), Online publication date: 1-Sep-2018. Volume 200Issue 1July 2018Page: 167-170 Advertisement Copyright & Permissions© 2018 by American Urological Association Education and Research, Inc.Keywordserectile dysfunctionpenisextracorporeal shock wave therapytreatment outcomerisk factorsMetricsAuthor Information Noam D. Kitrey Urology Department, Sheba Medical Center, Ramat-Gan, Israel More articles by this author Yoram Vardi Urology Department, Sheba Medical Center, Ramat-Gan, Israel Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel More articles by this author Boaz Appel Neurourology Unit, Rambam Healthcare Campus, Haifa, Israel Financial interest and/or other relationship with Medispec. More articles by this author Arik Shechter Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel Neurourology Unit, Rambam Healthcare Campus, Haifa, Israel More articles by this author Omar Massarwi Neurourology Unit, Rambam Healthcare Campus, Haifa, Israel More articles by this author Yasmin Abu-Ghanem Urology Department, Sheba Medical Center, Ramat-Gan, Israel More articles by this author Ilan Gruenwald Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel Neurourology Unit, Rambam Healthcare Campus, Haifa, Israel More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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